Safe · KLOE 2
Managing risks during care and treatment
Is care and treatment planned and monitored to identify and manage risks, emergencies, and deterioration?
CQC wording, primary care and community services draft V6.0, pages 6 to 8.
Draft, not the current assessment framework
CQC's primary care and community services draft V6.0, published March 2026. The current quality statements remain in use.
CQC draft scope
What this proposed KLOE covers
Scope of this key line of enquiry and topic areas include:
- Managing deterioration and emergencies
- Clinical risk
- Clinical records
- Restrictive practice
How would this apply to your service?
The draft applies one framework across primary care and community services, but useful evidence depends on your service and people.
Source: CQC, Primary care and community services assessment framework, draft V6.0, 19 March 2026, pages 6 to 8. Contains public sector information licensed under the Open Government Licence v3.0.
CQC draft rating characteristics
How the draft describes each rating
These are CQC's draft characteristics. CQC says rating characteristics guide judgements, they are not a mechanical checklist.
Outstanding
- There is a transparent and open culture that encourages creative thinking in relation to people’s individual safety. The service is an exemplar of consistently applying person-centred care, where risks are understood and managed for each individual person, as well as population groups.
- The service has embedded clinical systems and processes for identifying deteriorating patients and taking timely corrective action to stabilise and prevent further deterioration.
- People are actively involved in managing their own risks together with those that are close to them.
- People and those close to them are encouraged to raise concerns about the safety of their care. They are listened to, and appropriate steps are taken to address their concerns while keeping them fully informed throughout.
- The service proactively seeks out new and creative solutions to ensure that people live with as few restrictions as possible.
Good
- Specific risks to individual people, as well as population groups, are well understood and their care is monitored and assured for safety. People’s care plans reflect any foreseeable risks and how they should be managed.
- Deterioration, emergencies and clinical risks are proactively identified and managed to reduce harm. Emergency protocols, emergency medicines and resuscitation equipment are accessible, and staff are fully trained in their use. There are clear and understood processes for timely and effective escalation of care in the event of deterioration or an emergency.
- People and those close to them are informed and involved in how their care and individual treatments are delivered and managed, including potential risks and side effects. Their concerns are listened to and acted on.
- There is a balanced and proportionate approach to risk that supports people and respects the choices they make about their care and treatment.
- People are listened to when they raise concerns about the safety of their care.
- When people suffer avoidable medical harm, they get the support they need.
- People’s care plans and clinical records are accurate and kept up-to-date to allow the safe delivery of care and treatment. They reflect any foreseeable risks and how these should be managed.
- The service takes a proportionate approach to imposing restrictions on people. Restraint is only ever used as a last resort. If staff use restraint, it is necessary, lawful, for a legitimate purpose, safe, and staff follow best practice.
Requires improvement
- Specific risks to individual people or population groups are not fully understood. People’s care plans may be incomplete or generic and do not always consider future risks and mitigations.
- The management of deterioration, emergencies and clinical risks is inconsistent.
- Risk assessments exist but may not be proportionate and do not always consider people’s choices. This may lead to unnecessary restrictions or gaps in safety.
- People are not always listened to when they raise concerns about the safety of their care.
- People’s care plans and clinical records may be incomplete or generic and do not always cover foreseeable risks and how they should be managed.
- The approach to imposing restrictions on people is not always proportionate and there may be examples of inappropriate use of restraint.
Inadequate
- Risks to individual people or population groups are not understood or are ignored, leaving people exposed to avoidable harm or the risk of harm occurring. Care plans are missing, incomplete or inaccurate and do not predict foreseeable risks.
- Deterioration, emergencies and clinical risks are not well managed.
- There is no process to manage risk effectively.
- People’s choices about care and treatment are either not listened to or not considered.
- People are not listened to when they raise concerns about the safety of their care. Their voices are ignored or dismissed.
- Care plans and clinical records are missing, incomplete or inaccurate and do not predict foreseeable risks.
- The approach to imposing restrictions on people is disproportionate. Restraint is used in place of other more appropriate options.
Want to know how your service would fare?
Book a mock inspection run against the draft KLOEs, or call 020 8090 5346 to speak to one of our experts.